The now-40-year-old hopes others learn to recognize bladder cancer warning signs and "advocate for yourself and get checked out early."
A seemingly healthy 39-year-old man noticed blood in his urine, and it turned out to be a symptom of bladder cancer.
James "Jimi" Stewart says he was living a full and active life in the Austin area of Texas before his diagnosis.
"You'd find me out rollerblading with friends, paddleboarding, tubing and really soaking up everything the outdoors has to offer," Stewart, now 40, tells PEOPLE exclusively.
"My health really wasn't on my radar, though. I had been a smoker, but honestly, health concerns were not top of mind for me," he continues. "I was 39, active and enjoying my life. I never expected anything like this to come my way."
However, everything changed on an otherwise normal day, with a symptom that Stewart describes as "almost minor."
"I noticed blood in my urine. It was alarming, certainly, but I don't think I fully appreciated at the time just how significant that sign would turn out to be," he says, adding that he later learned blood in the urine is actually "one of the key warning signs" of bladder cancer.
"What began as one concerning symptom led to a shocking diagnosis -- non-muscle-invasive bladder cancer (NMIBC)," he says, adding that he is "grateful" he didn't wait to get things checked out.
Stewart recalls that receiving the diagnosis was initially "numbing."
"There's almost this disbelief that washes over you, like your brain can't fully process what it's being told. But that numbness didn't last long. It became very real, very fast," he explains.
He says the diagnosis "hit differently" because of his age.
"Bladder cancer is typically diagnosed in adults 55 and older, so being diagnosed with non-muscle-invasive bladder cancer at 39 added another layer to everything," he tells PEOPLE.
"You're not supposed to be thinking about cancer at this point in your life. I was still building my future, thinking about relationships, staying active and living fully," he says, adding that the possibility of bladder removal was a "very real" and scary possibility. "I kept thinking about how drastically that could change the years ahead of me."
The recovery care technician supervisor said he first tried a treatment option called Bacillus Calmette-Guérin (BCG), which is considered the standard first-line treatment for his specific form of the disease.
However, BCG did not work.
Stewart says he was determined to explore all his treatment options before resorting to bladder removal surgery, and his medical team respected and facilitated that decision.
"My team introduced me to INLEXZO, a new treatment advancement that was FDA-approved in September 2025," he explains.
Stewart became the first commercial patient in Texas to receive the treatment, which entails a drug-releasing system placed directly into the bladder by a urologist.
"Once it's in, I don't even feel it. And it works for me and my lifestyle," he says.
"I was ultimately able to receive it at no cost through a patient assistance program called INLEXZO withMe. That was an incredible blessing, and it's something I really want others to know about," he adds.
Stewart is currently approaching his eighth and final induction dose of INLEXZO, and he has been declared cancer-free.
"My scans have come back clear, meaning no evidence of active cancer. Those are words I desperately wanted to hear, but I wasn't sure they would ever reach my ears. They still fill me up with both relief and gratitude," he tells PEOPLE, adding that he will soon shift to a quarterly dosing schedule and continue treatment for a year and a half.
While the treatment has proven effective for Stewart, he also stresses that the road forward has not been easy.
"As with any treatment, there have been some difficult moments. Bladder cancer symptoms, like frequent urination and UTIs, are challenging," he says.
However, he has a "wonderful physician assistant" whom he feels "completely comfortable speaking to and actively partnering with to find solutions."
As for what Stewart wants others to learn when it comes to bladder cancer?
"Know the warning signs," he says. "Blood in urine is a key one, as well as overly frequent urination. Don't dismiss it. Advocate for yourself and get checked out early."
"Bladder cancer is not just an older person's disease, and the sooner it's caught, the more options you have," he adds.
Stewart also urges people to "explore all your options before accepting anything that's going to alter your life."
"If you're facing bladder removal, ask your doctor whether you're a candidate for treatments like mine," he advises.
"INLEXZO has recently become even more accessible for qualifying patients and easier for medical practices to receive reimbursement, so if this treatment felt out of reach before, it may not be anymore. Please look into it," Stewart adds.
“And finally, stay positive,” he says. “Cancer is not just a physical fight. It challenges you emotionally and mentally as well. But even in the darkest moments, there is a reason to hold on to hope.”
Stewart additionally recommends cancer advocacy organizations like the Bladder Cancer Advocacy Network, Triage Cancer and Man Up to Cancer.
"What started as one of the hardest experiences of my life has, in a lot of ways, turned into something meaningful and unexpectedly positive," Stewart tells PEOPLE.
"Through sharing my story, I've had the opportunity to connect with others who are fighting similar battles and help raise awareness about where bladder cancer treatment is headed," he adds.